Remote Talk Therapy May Benefit Homebound Caregivers

German study shows those caring for loved ones with dementia aided by cognitive behavior conversations

Specific therapies available by phone were found to have health advantages for caregivers.

Cognitive Behavioral Therapy (CBT) delivered via phone may improve the physical and emotional health of caregivers of dementia patients better than community resources, according to a new German study.

CBT, which is a type of psychotherapy, uses a limited number of sessions to enhance skills for responding to stressful or difficult situations and emotions. However, CBT is often unavailable to many homebound caregivers of dementia patients, because it is typically delivered face-to-face. Writers for the study, published in The Gerontologist, said that CBT has unique benefits to offer.

“CBT is always better than psycho-educational strategies, or support groups,” lead author Gabriele Wilz of Freidrich Schiller University in Jena, Germany, told Reuters Health. “Psycho-education is important, but not sufficient, for example, to cope with burdensome emotions, or learn new strategies to cope with challenging behavior, or to change dysfunctional thoughts, or to promote recreation time for the caregivers.”

Researchers randomly assigned 273 family caregivers of a dementia patient to either individual telephone-based CBT, or to a control group that only had access to their usual community resources. At the beginning of the study all participants had higher levels of depression, physical pains and heart symptoms than the noncaregiving population. At six months the telephone CBT caregiver group reported less depression and physical pain, and positive changes in their emotional health and ability to cope with the often-challenging behaviors exhibited by their loved one with dementia. At the 12-month mark, while there was not much difference between the groups in depression or physical health levels, the CBT group continued to experience greater feelings of well-being and felt better able to cope with their loved one's condition.

“Unlike someone who might be depressed in another context, these caregivers have unremitting demands and burdens. Someone is not magically going to make them go to sleep and have a full night,” Lisa Onken, director of the behavior change and intervention program at the U.S. National Institute on Aging, told Reuters. Onken, who was not involved in the study, noted that while it was promising, more studies are needed on the topic. "It fits easily into Germany’s health care system, but it’s not clear how it fits in with the health care system in the U.S.,” she said.